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Belciug S, Gabriel Iliescu D. Deep Learning and Gaussian Mixture Modelling clustering mix. A new approach for fetal morphology view plane differentiation. J Biomed Inform 2023; 143:104402. [PMID: 37217028 DOI: 10.1016/j.jbi.2023.104402] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/05/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
The last three years have been a game changer in the way medicine is practiced. The COVID-19 pandemic changed the obstetrics and gynecology scenery. Pregnancy complications, and even death, are preventable due to maternal-fetal monitoring. A fast and accurate diagnosis can be established by a doctor + Artificial Intelligence combo. The aim of this paper is to propose a framework designed as a merger between Deep learning algorithms and Gaussian Mixture Modelling clustering applied in differentiating between the view planes of a second trimester fetal morphology scan. The deep learning methods chosen for this approach were ResNet50, DenseNet121, InceptionV3, EfficientNetV2S, MobileNetV3Large, and Xception. The framework establishes a hierarchy of the component networks using a statistical fitness function and the Gaussian Mixture Modelling clustering method, followed by a synergetic weighted vote of the algorithms that gives the final decision. We have tested the framework on two second trimester morphology scan datasets. A thorough statistical benchmarking process has been provided to validate our results. The experimental results showed that the synergetic vote of the framework outperforms the vote of each stand-alone deep learning network, hard voting, soft voting, and bagging strategy.
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Affiliation(s)
- Smaranda Belciug
- Department of Computer Science, Faculty of Sciences, University of Craiova, Craiova, 200585, Romania.
| | - Dominic Gabriel Iliescu
- Department of Computer Science, Faculty of Sciences, University of Craiova, Craiova, 200585, Romania; Department no. 2, University of Medicine and Pharmacy of Craiova, Romania.
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Fischbein R, Welsh H, Ernst-Milner S, Nicholas L. Patient-Reported Monochorionic-Diamniotic Twin Pregnancy Management and Experiences During the COVID-19 Pandemic: A Mixed-Methods Cross-Sectional Survey. J Patient Exp 2022; 9:23743735221133634. [PMID: 36330231 PMCID: PMC9623371 DOI: 10.1177/23743735221133634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Monochorionic-diamniotic (MCDA) pregnancies are high-risk necessitating ongoing
screening for serious complications and quick decision-making. COVID-19 pandemic
protocols introduced unique challenges to pregnancy management and patient
experience. In late 2021, an online, mixed-methods, cross-sectional survey
recruited 561 participants who experienced an MCDA pregnancy within five years.
Analyses included descriptive and bivariate statistics and thematic analysis.
Findings suggest the pandemic did not negatively affect screening/diagnosis for
these participants. Care consistent with guidelines was received by most, with
care slightly better during the pandemic. Almost 80% (79.0%) received an MCDA
diagnosis by gestational week 14 before the pandemic, 87.8% during. Most
received biweekly ultrasounds, 88.0% prior to the pandemic, 88.9% during.
Experiences were affected in other ways for almost 44% of participants pregnant
during COVID-19; in ways likely shared by other high-risk pregnancies. Thematic
analysis revealed management during COVID-19 impacted self-advocacy and emotions
(eg, alienation, anxiety), made care seem impersonal, and resulted in delayed or
canceled appointments. Policies should be considered, so future healthcare
disruptions do not impact patients and preserve in-person health care with
access to a support person.
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Affiliation(s)
- Rebecca Fischbein
- Northeast Ohio Medical University, Rootstown, OH, USA,Rebecca Fischbein, Department of Family and
Community Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA.
| | - Hannah Welsh
- Northeast Ohio Medical University, Rootstown, OH, USA
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Wake AD. Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis. Interdiscip Perspect Infect Dis 2022; 2022:2443785. [PMID: 36262688 PMCID: PMC9576430 DOI: 10.1155/2022/2443785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/04/2022] [Accepted: 09/23/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs). Methods Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles. Results A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection. Conclusion This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Asella, Ethiopia
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Heidarzadeh M, Taheri M, Mazaheripour Z, Abbasi-Khameneh F. The incidence of congenital anomalies in newborns before and during the Covid-19 pandemic. Ital J Pediatr 2022; 48:174. [PMID: 36109775 PMCID: PMC9479418 DOI: 10.1186/s13052-022-01368-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pregnant women are one of the most vulnerable groups in the Covid-19 pandemic. Due to the lack of knowledge about fetal and perinatal complications following Covid-19 infection, the association of Covid-19 pandemic and congenital anomalies in babies conceived and born during this pandemic is unclear. Current study aimed to investigate the association between the Covid-19 pandemic and congenital birth anomalies in Iran. The population of newborns whose embryonic period coincided with the Covid-19 crises were compared with a similar group born during the pre-Covid-19 period.
Methods
This is a retrospective comparative analysis of congenital birth anomalies in Iran; desired data was extracted from national birth registry database. All registered congenital anomalies in hospital births were compared between two time periods: During Covid-19 (1st November 2020- 28th February 2021) and Before Covid-19 (1st November 2019-29th February 2020). Incidence of congenital anomalies at birth were compared and analyzed between these two time periods.
Results
The incidence of congenital birth anomalies are significantly increased during Covid-19 pandemic compared with before Covid-19 (P value < 0.00001). The number of all types of anomalies has increased in the current pandemic, but the congenital anomalies of the central nervous system (P value = 0.04) and Genitourinary (P value = 0.03) have a larger contribution than before.
Conclusion
Covid-19 pandemic are associated with congenital anomalies at birth. There are several factors in the Covid-19 pandemic which can affect fetal development in the first trimester of pregnancy. Possible reasons include vertical transmission of Covid-19 infection; maternal fever, stress and anxiety; insufficient preconception and prenatal care; neglect of fetal screening; and poverty imposed by this pandemic.
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Belciug S. Learning deep neural networks' architectures using differential evolution. Case study: Medical imaging processing. Comput Biol Med 2022; 146:105623. [PMID: 35751202 PMCID: PMC9112664 DOI: 10.1016/j.compbiomed.2022.105623] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/03/2022] [Accepted: 03/31/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has changed the way we practice medicine. Cancer patient and obstetric care landscapes have been distorted. Delaying cancer diagnosis or maternal-fetal monitoring increased the number of preventable deaths or pregnancy complications. One solution is using Artificial Intelligence to help the medical personnel establish the diagnosis in a faster and more accurate manner. Deep learning is the state-of-the-art solution for image classification. Researchers manually design the structure of fix deep learning neural networks structures and afterwards verify their performance. The goal of this paper is to propose a potential method for learning deep network architectures automatically. As the number of networks architectures increases exponentially with the number of convolutional layers in the network, we propose a differential evolution algorithm to traverse the search space. At first, we propose a way to encode the network structure as a candidate solution of fixed-length integer array, followed by the initialization of differential evolution method. A set of random individuals is generated, followed by mutation, recombination, and selection. At each generation the individuals with the poorest loss values are eliminated and replaced with more competitive individuals. The model has been tested on three cancer datasets containing MRI scans and histopathological images and two maternal-fetal screening ultrasound images. The novel proposed method has been compared and statistically benchmarked to four state-of-the-art deep learning networks: VGG16, ResNet50, Inception V3, and DenseNet169. The experimental results showed that the model is competitive to other state-of-the-art models, obtaining accuracies between 78.73% and 99.50% depending on the dataset it had been applied on.
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Wake AD. Intrauterine Vertical Transmission of SARS-CoV-2 Infection Among Confirmed Cases of Pregnant Women: “A Double Burden for the Pregnant Women”—A Systematic Review. Glob Pediatr Health 2022; 9:2333794X221089765. [PMID: 35386229 PMCID: PMC8977699 DOI: 10.1177/2333794x221089765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. The world health organization (WHO) has declared the outbreak of novel coronavirus (2019-nCoV), which is now known as Coronavirus Disease 2019 (COVID-19). Whereas, its quick global spread has resulted in a worldwide pandemic. The present review article was intended to evaluate intrauterine vertical transmission of SARS-CoV-2 infection among confirmed cases of pregnant women. Methods. Web of Science, EMBASE, PubMed, African Journals OnLine, Scopus, PsycINFO, HINARI, Cochrane Library, Wiley Online Library, and Google scholar were used for search. Result. A total of 43 articles were included in to this systematic review. A total of 1,300 neonates born from pregnant women confirmed for COVI-19 were tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (RT-PCR). From the 1,300 neonates tested for SARS-CoV-2 infection, 93 neonates were found positive for this infection by RT-PCR. From this systematic review finding, the vertical transmission rate of SARS-CoV-2 infection was 7.15%. This pandemic has stressed the entire public, particularly pregnant women and healthcare providers, while it challenged antenatal care and postnatal care by far. Thus, even being under lockdown in the middle of a global pandemic is stressful enough. Therefore, imagine the added burden of being pregnant, which could be a double burden for these women. Conclusion. There is no concrete evidence of vertical transmission of SARS-CoV-2. Therefore, due to the limited number of clinical evidences, obstetricians, pediatricians, and other healthcare providers should continuously update their knowledge and be conscious about the transmission of SARS-CoV-2 vertically during pregnancy.
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Jamshidnezhad A, Hosseini SM, Mahmudi M, Mohammadi-Asl J. A machine learning technology to improve the risk of non-invasive prenatal tests. Technol Health Care 2022; 30:951-965. [PMID: 35275583 DOI: 10.3233/thc-213628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Timely and accurate diagnosis of genetic diseases can lead to proper action and prevention of irreparable events. OBJECTIVE In this work we propose an integrated genetic-neural network (GNN) to improve the prediction risk of trisomy diseases including Down's syndrome (T21), Edwards' syndrome (T18) and Patau's Syndrome (T13). METHODS A dataset including 561 pregnant were created. In this integrated model, the structure and input parameters of the proposed multilayer feedforward network (MFN) were optimized. RESULTS The results of execution of the GNN on the testing dataset showed that the developed model can be accurately classify the anomalies from healthy fetus with 97.58% accuracy rate, and 99.44% and 85.65% sensitivity, and specificity, respectively. In the proposed GNN model, the Levenberg Merquident (LM) algorithm, the Radial Basis (Radbas) function from various types of functions were selected by the proposed GA. Moreover, maternal age, Nuchal Translucency (NT), Crown-rump length (CRL), Pregnancy-associated plasma protein A (PAPP-A) were selected by the proposed GA as the most effective factors for classifying the healthfetuses from the cases with fetal disorders. CONCLUSION The proposed computerized model increases the diagnostic performance of the physicians especially in the accurate detection of healthy fetus with non - invasive and low - cost treatments.
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Affiliation(s)
- Amir Jamshidnezhad
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Health Information Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohsen Hosseini
- Department of Health Information Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mandana Mahmudi
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Javad Mohammadi-Asl
- Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Carbone L, Raffone A, Sarno L, Travaglino A, Saccone G, Gabrielli O, Migliorini S, Sirico A, Genesio R, Castaldo G, Capponi A, Zullo F, Rizzo G, Maruotti GM. Invasive prenatal diagnosis during COVID-19 pandemic. Arch Gynecol Obstet 2022; 305:797-801. [PMID: 34618213 PMCID: PMC8495187 DOI: 10.1007/s00404-021-06276-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/01/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Luigi Carbone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy.
| | - Laura Sarno
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Olimpia Gabrielli
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Sonia Migliorini
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Angelo Sirico
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Rita Genesio
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - Alessandra Capponi
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Maria Maruotti
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Via Sergio Pansini no. 5, 80131, Naples, Italy
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Czuba B, Mlodawski J, Kajdy A, Sys D, Cnota W, Mlodawska M, Kwiatkowski S, Guzik P, Wielgos M, Rybak-Krzyszkowska M, Fuchs A, Swiercz G, Borowski D. Implementation of the Publicly Funded Prenatal Screening Programme in Poland during the COVID-19 Pandemic: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11051317. [PMID: 35268408 PMCID: PMC8911175 DOI: 10.3390/jcm11051317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/14/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
The COVID-19 pandemic in 2020 affected the entire healthcare system in Poland, causing medical personnel to be relocated to other duties and limiting patients’ contacts with healthcare professionals. A large part of the planned diagnostics and treatment was delayed due to lack of equipment and personnel. Against this background, we analysed the implementation of the publicly funded prenatal screening programme (PSP) in Poland compared to the previous year. This is a cross-sectional study. We used nationwide datasets on the implementation of the prenatal testing programme over the period 2019−2020, datasets from the Statistics Poland on birth and the data on the development of the COVID-19 epidemic in Poland. In the year 2020, we observed a 12.41% decrease in woman enrolled to the programme compared to 2019. However, the decrease concerned only women under 35 years of age. With respect to the number of deliveries in the calendar year, the number of patients enrolled in the programme decreased by 3% (31% vs. 34%, p < 0.001). We also observed an increase in estriol measurements per the number of patients included in the programme, and a reduction in the number of PAPP-A tests in the first trimester, which proves an increased share of the triple test in the prenatal diagnosis of chromosomal aberrations. With respect to the number of deliveries, the number of amniocentesis procedures performed under PSP decreased by 0.19% (1.8% vs. 1.99%, p < 0.0001). In 2020, compared to the previous year, the number of patients included in the prenatal testing programme in Poland decreased. In terms of the number of births in Poland, the number of integrated screening tests also decreased, at the expense of increasing the percentage of triple tests. There were also significant reductions in the number of invasive diagnostic tests.
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Affiliation(s)
- Bartosz Czuba
- Chair and Department of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, 41-703 Ruda Śląska, Poland; (B.C.); (W.C.)
| | - Jakub Mlodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (M.M.); (G.S.)
- Correspondence:
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.K.); (D.S.)
| | - Dorota Sys
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.K.); (D.S.)
| | - Wojciech Cnota
- Chair and Department of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, 41-703 Ruda Śląska, Poland; (B.C.); (W.C.)
| | - Marta Mlodawska
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (M.M.); (G.S.)
| | - Sebastian Kwiatkowski
- Department Obstetrics and Gynecology, Pommeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Pawel Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland;
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Genocology, Medical University of Warsaw, 02-015 Warsaw, Poland;
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland;
| | - Anna Fuchs
- Chair and Department of Gynecology, Obstetrics and Oncological Gynecology, Medical University of Silesia in Katowice, 40-211 Katowice, Poland;
| | - Grzegorz Swiercz
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (M.M.); (G.S.)
| | - Dariusz Borowski
- Department of Perinatology, Gynaecology and Gynaecologic Oncology, The Faculty of Health Sciences, Collegium Medicum, Nicolaus Coeprnicus University, 85-067 Bydgoszcz, Poland;
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Gold S, Clarfield L, Johnstone J, Diambomba Y, Shah PS, Whittle W, Abbasi N, Arzola C, Ashraf R, Biringer A, Chitayat D, Czikk M, Forte M, Franklin T, Jacobson M, Keunen J, Kingdom J, Lapinsky S, MacKenzie J, Maxwell C, Preisman M, Ryan G, Selk A, Sermer M, Silversides C, Snelgrove J, Watts N, Young B, De Castro C, D'Souza R. Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review. BMC Pregnancy Childbirth 2022; 22:119. [PMID: 35148698 PMCID: PMC8840792 DOI: 10.1186/s12884-022-04409-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 01/18/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction. METHOD Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations. RESULTS We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options. INTERPRETATION There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability.
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Affiliation(s)
- Shira Gold
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Jennie Johnstone
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Yenge Diambomba
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Prakesh S Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Wendy Whittle
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nimrah Abbasi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Cristian Arzola
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rizwana Ashraf
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Anne Biringer
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - David Chitayat
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Marie Czikk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Milena Forte
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Tracy Franklin
- Department of Family and Community Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michelle Jacobson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Johannes Keunen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Kingdom
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Joanne MacKenzie
- Department of Nursing, Mount Sinai Hospital, Toronto, ON, Canada
| | - Cynthia Maxwell
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mary Preisman
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | - Greg Ryan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Amanda Selk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mathew Sermer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Candice Silversides
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Snelgrove
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nancy Watts
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Beverly Young
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | | | - Rohan D'Souza
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada.
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11
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Efendi D, Hasan F, Natalia R, Utami AR, Sonko I, Asmarini TA, Yuningsih R, Wanda D, Sari D. Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review. PLoS One 2022; 17:e0263267. [PMID: 35113925 PMCID: PMC8812980 DOI: 10.1371/journal.pone.0263267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.
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Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, Indonesia
| | - Faizul Hasan
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Regina Natalia
- School of Nursing, Mitra Bunda Health Institute, Batam, Indonesia
| | - Ayuni Rizka Utami
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Ismaila Sonko
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Ministry of Health and Social Welfare, The Quadrangle, Banjul, The Gambia, West Africa
| | - Titik Ambar Asmarini
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal and Pediatric Intensive Care Unit, Gatot Soebroto Indonesian Central of Army Hospital, Jakarta, Indonesia
| | - Risna Yuningsih
- Neonatal Intensive Care Unit, Dr. Dradjat Prawiranegara General Hospital, Banten, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Dian Sari
- School of Nursing, Prima Nusantara Health Institute, Bukittinggi, Indonesia
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12
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Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors. Vaccines (Basel) 2022; 10:vaccines10010110. [PMID: 35062771 PMCID: PMC8779795 DOI: 10.3390/vaccines10010110] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/12/2022] Open
Abstract
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic.
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13
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Belciug S, Ivanescu RC, Popa SD, Iliescu DG. Doctor/Data Scientist/Artificial Intelligence Communication Model. Case Study. PROCEDIA COMPUTER SCIENCE 2022; 214:18-25. [PMID: 36514710 PMCID: PMC9729980 DOI: 10.1016/j.procs.2022.11.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The last two years have taught us that we need to change the way we practice medicine. Due to the COVID-19 pandemic, obstetrics and gynecology setting has changed enormously. Monitoring pregnant women prevents deaths and complications. Doctors and computer data scientists must learn to communicate and work together to improve patients' health. In this paper we present a good practice example of a competitive/collaborative communication model for doctors, computer scientists and artificial intelligence systems, for signaling fetal congenital anomalies in the second trimester morphology scan.
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Affiliation(s)
- Smaranda Belciug
- University of Craiova, A.I. Cuza Str, no 13, Craiova, 200585, Romania
| | | | | | - Dominic Gabriel Iliescu
- University of Craiova, A.I. Cuza Str, no 13, Craiova, 200585, Romania
- University of Medicine and Pharmacy, Petru Rares Str, no. 2, 200349, Romania
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14
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Editorial: Does it take a pandemic to get pregnant? Curr Opin Obstet Gynecol 2021; 33:419-420. [PMID: 34459794 DOI: 10.1097/gco.0000000000000738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Wake AD. The Acceptance Rate Toward COVID-19 Vaccine in Africa: A Systematic Review and Meta-analysis. Glob Pediatr Health 2021; 8:2333794X211048738. [PMID: 34616860 PMCID: PMC8488505 DOI: 10.1177/2333794x211048738] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 01/09/2023] Open
Abstract
Background: The Coronavirus Disease 2019 (COVID-19) pandemic remains serious public issue. COVID-19 vaccine is a vital strategy to prevent this critical pandemic. However, unwillingness to take this vaccine are key barriers to manage the COVID-19 pandemic. The control of this pandemic will depend principally on the people acceptance of COVID-19 vaccine. Therefore, this systematic review and meta-analysis was intended to determine the acceptance rate toward COVID-19 vaccine in Africa. Methods: African Journals OnLine, PubMed, Cochrane Review, HINARI, EMBASE, Google Scholar, Web of Science, and Scopus were used to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Random-effect model, a funnel plot, Egger's test, I 2 statistic, subgroup analysis was done. The study was performed by using a STATA version 11 statistical software. Results: A total of 22 studies with 33,912 study participants were included in this systematic review and meta-analysis. From this finding, the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was 48.93% (95% CI: [39.49, 58.37]). The subgroup analysis revealed that the pooled prevalence of COVID-19 vaccine acceptance among adults in Africa was highest (66.03%, 95% CI [62.84, 69.22]) in Southern Africa, and Lowest (24.28%, 95% CI [3.26, 45.30]) in Northern Africa. Conclusion: This study showed that the estimate of the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was very low. All concerned bodies should be actively involved to improve the acceptance rate of COVID-19 vaccine.
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16
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Wake AD. The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: "Vaccination Refusal Could Prolong the War of This Pandemic" - A Systematic Review. Risk Manag Healthc Policy 2021; 14:2609-2623. [PMID: 34188572 PMCID: PMC8232962 DOI: 10.2147/rmhp.s311074] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, spreads globally, since its declaration by the World Health Organization (WHO) as a COVID-19 pandemic on March 11, 2020. COVID-19 vaccine is a crucial preventive approach that can halt this pandemic. The present systematic review was aimed to assess the level of willingness to receive COVID-19 vaccine and its associated factors. METHODS A comprehensive literature search was conducted by using various online databases such as PubMed/MEDLINE, HINARI, EMBASE, Google Scholar, Web of Science, Scopus, African journals, and Google for grey literature which were used to search the related articles up to the period of May 08, 2021. RESULTS The overall rate of participants' willingness to receive the COVID-19 vaccine was ranged from 27.7% to 91.3%, which was from Congo and China, respectively. Factors such as age, educational status, gender, income, residency, occupation, marital status, race/ethnicity, perceived risk of COVID-19, trust in healthcare system, health insurance, norms, attitude towards vaccine, perceived benefit of vaccine, perceived vaccine barriers, self-efficacy, up-to-date on vaccinations, tested for COVID-19 in the past, perceived efficacy of the COVID-19 vaccination, recommended for vaccination, political leaning, perceived severity of COVID-19, perceived effectiveness of COVID-19 vaccine, belief that vaccination makes them feel less worried about COVID-19, believing in mandatory COVID-19 vaccination, perceived potential vaccine harms, presence of chronic disease, confidence, COVID-19 vaccine safety concern, working in healthcare field, believing vaccines can stop the pandemic, fear about COVID-19, cues to action, COVID-19 vaccine hesitancy, complacency, and receiving any vaccine in the past 5 years were associated with the willingness of receive COVID-19 vaccine. CONCLUSION There were insufficient levels of willingness to receive COVID-19 vaccine, and several factors were associated with it. Health education should be provided concerning this vaccine to improve the willingness of the community.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Asella, Ethiopia
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17
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Yapar Eyi EG, Moraloglu Tekin O, Buglagil A, Sahin D, Yucel A, Tanacan A, Halici Ozturk F, Yakistiran B, Yucel Yetiskin D, Unlu S, Gokcinar D. Perinatology clinic in the coronavirus disease-2019 pandemic: what harms, often teaches. J Matern Fetal Neonatal Med 2021; 34:3591-3600. [PMID: 33645392 DOI: 10.1080/14767058.2021.1875440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Compartmental models simplify the mathematical modeling of infectious diseases based on reported cases. In the absence of precautions, personal protective equipment, quarantine and social distancing, a Susceptible-Exposed-Infectious-Recovered (SuEIR) model with Unscented Kalman Filter for coronavirus disease-19 (COVID-19) Forecasts in Turkey has revealed 174 641 infected people on August 15, 2020, whilst the reported case was 12 216. Through numerical experiments, the effects of quarantine, social distancing, and COVID-19 testing on the dynamics of the outbreak varies. We herein present the documentation of the work in a perinatology clinic during COVID-19 pandemic to find the reflection in a pandemic hospital as even in the pandemic, pregnancy complications and fetal diagnosis/therapy are time-sensitive and cannot be delayed. During the prevention of the horizontal transmission to the health-care workers (HCWs), testing all pregnant women with nasopharyngeal/oropharyngeal swabs for severe acute respiratory syndrome coronavirus (SARS-COV-2) undergoing birth, ultrasound examinations, invasive procedures appear to be the gold standard so that appropriate precautions can be taken if the screen is positive. Though it is logical, it may be incompatible with a busy obstetric practise as a pending polymerase chain reaction (PCR) result should never delay any emergent procedure. OBJECTIVE We aim to describe the development of COVID-19 disease of 408 HCW out of 1462 by the exposure to pregnant women while providing obstetric care in a single tertiary perinatology unit under strict clinical triage, recommended precautions and wearing personal protective equipment and compare the maternal and perinatal outcome with those of the preceding three months. STUDY DESIGN A prospective cohort study involving the pregnant women and the HCW with positive PCR for SARS-COV-2 were carried out to correlate with the horizontal transmission while documenting the perinatal work. RESULTS 25 HCW, including nurses/midwives: 11, doctors: 7 and health technicians: 3 and support staff: 4 developed positive PCR for SARS-COV-2 while providing healthcare to 162 cases: mild-moderate (n = 146), severe (n = 12) and critical (n = 1) and asymptomatic (n = 3) in obstetric population. 22 out of 25 HCW were working in the perinatology unit. COVID-19 clinic was asymptomatic (n = 8), mild-moderate (13) or severe (n = 2) in HCW. However, "Exposed" group in the SuEIR model, both the pregnant women and the HCW that have already been infected and have not been tested, which have been also capable of infecting the "Susceptible" group could not be determined. Some of the HCW and the pregnant women in the "Exposed" group were tested and transferred to the "Infectious" group (which were reported to be PCR positive), while the rest of them who recovered, transitted to the so-called "Unreported Recovered" group. The ratio of the women with severe pre-eclampsia admitted to intensive care unit increased significantly during the lockdown (p = .01). CONCLUSIONS In a nonstop pandemic perinatology clinic, exposure to 162 PCR positive pregnant women may be correlated with a 5.4% (22/408) documented horizontal transmission in the frontline HCW despite clinical triage and personal protective equipment.
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Affiliation(s)
| | | | - Arda Buglagil
- Department of Electrical and Electronics Engineering, Bilkent University, Bilkent, Ankara, Turkey
| | - Dilek Sahin
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Aykan Yucel
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Atakan Tanacan
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | | | - Betul Yakistiran
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | | | - Serpil Unlu
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Derya Gokcinar
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
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18
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Smith VJ, Marshall A, Lie MLS, Bidmead E, Beckwith B, Van Oudgaarden E, Robson SC. Implementation of a fetal ultrasound telemedicine service: women's views and family costs. BMC Pregnancy Childbirth 2021; 21:38. [PMID: 33419397 PMCID: PMC7793392 DOI: 10.1186/s12884-020-03532-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/28/2020] [Indexed: 12/26/2022] Open
Abstract
Background The complexity of fetal medicine (FM) referrals that can be managed within obstetric units is dependent on the availability of specialist ultrasound expertise. Telemedicine can effectively transfer real-time ultrasound images via video-conferencing. We report the successful introduction of a fetal ultrasound telemedicine service linking a specialist fetal medicine (FM) centre and a remote obstetric unit. Methods Over a four-year period from October 2015, all women referred for FM consultation from the obstetric unit were seen via telemedicine, excluding cases where invasive testing, intrauterine therapy or cardiac anomalies were anticipated. The outcomes measured included the indication for FM referral; scan duration and image and sound quality during the consultation. Women’s perceptions of the telemedicine consultation and estimated costs to attend the FM centre were measured by a structured questionnaire completed following the first telemedicine appointment during the Phase 1 of the project. Results Overall, 297 women had a telemedicine consultation during Phase 1 (pilot and evaluation) and Phase 2 (embedding and adoption) of the project, which covered a 4 year period 34 women completed questionnaires during the Phase 1 of the study. Travel to the telemedicine consultation took a median (range) time of 20 min (4150), in comparison to an estimated journey of 230 min (120,450) to the FM centre. On average, women would have spent approximately £28 to travel to the FM centre per visit. The overall costs for the woman and her partner/ friend to attend the FM centre was estimated to be £439. Women were generally satisfied with the service and valued the opportunity to have a FM consultation locally. Conclusions We have demonstrated that a fetal ultrasound telemedicine service can be successfully introduced to provide FM ultrasound of sufficient quality to allow fetal diagnosis and specialist consultation with parents. Furthermore, the service is acceptable to parents, has shown a reduction in family costs and journey times. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03532-4.
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Affiliation(s)
- V J Smith
- Northumbria University, G206, Coach Lane Campus, Newcastle upon Tyne, NE7 7XA, UK. .,The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - A Marshall
- University of Cumbria, Carlisle, Cumbria, UK
| | - M L S Lie
- Newcastle University, Newcastle upon Tyne, UK
| | - E Bidmead
- University of Cumbria, Carlisle, Cumbria, UK
| | - B Beckwith
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - S C Robson
- Newcastle University, Newcastle upon Tyne, UK
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19
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Wataganara T, Ruangvutilert P, Sunsaneevithayakul P, Sutantawibul A, Chuchotirot M, Phattanachindakun B, Russameecharoen K. Minimizing cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic. J Perinat Med 2020; 48:931-942. [PMID: 32681782 DOI: 10.1515/jpm-2020-0228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/28/2020] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated infection (COVID-19) is affecting populations worldwide. This statement may serve as guidance for infection prevention and safe ultrasound practices during the COVID-19 pandemic. Ultrasound examination is a fundamental part of obstetric care, yet it is a potential vector for transmission of SARS-CoV-2. Decontamination methods should always be implemented for ultrasound equipment, especially in the presence of suspected or confirmed COVID-19 cases. There must be workflow policies to protect pregnant women and healthcare providers from nosocomial cross transmission of SARS-CoV-2. Cleaning and disinfecting of equipment must be in accordance with their potential of pathogen transmission. Consider using telemedicine and genetic technologies as an adjunctive of obstetric ultrasound to reduce patient crowding. Patient triage and education of healthcare providers of infection prevention are crucial to minimize cross contamination of SARS-CoV-2 during obstetric ultrasound.
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Affiliation(s)
- Tuangsit Wataganara
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Pornpimol Ruangvutilert
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Prasert Sunsaneevithayakul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Anuwat Sutantawibul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Monsak Chuchotirot
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Buraya Phattanachindakun
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Kusol Russameecharoen
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
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20
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Abstract
In the spring of 2020, expeditious changes to obstetric care were required in New York as cases of COVID-19 increased and pandemic panic ensued. A reduction of in-person office visits was planned with provider appointments scheduled to coincide with routine maternal blood tests and obstetric ultrasounds. Dating scans were combined with nuchal translucency assessments to reduce outpatient ultrasound visits. Telehealth was quickly adopted for selected prenatal visits and consultations when deemed appropriate. The more sensitive cell-free fetal DNA test was commonly used to screen for aneuploidy in an effort to decrease return visits for diagnostic genetic procedures. Antenatal testing guidelines were modified with a focus on providing evidence-based testing for maternal and fetal conditions. For complex pregnancies, fetal interventions were undertaken earlier to avoid serial surveillance and repeated in-person hospital visits. These rapid adaptations to traditional prenatal care were designed to decrease the risk of coronavirus exposure of patients, staff, and physicians while continuing to provide safe and comprehensive obstetric care.
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21
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Mahyuddin AP, Kanneganti A, Wong JJL, Dimri PS, Su LL, Biswas A, Illanes SE, Mattar CNZ, Huang RYJ, Choolani M. Mechanisms and evidence of vertical transmission of infections in pregnancy including SARS-CoV-2s. Prenat Diagn 2020; 40:1655-1670. [PMID: 32529643 PMCID: PMC7307070 DOI: 10.1002/pd.5765] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
There remain unanswered questions concerning mother‐to‐child‐transmission of SARS‐CoV‐2. Despite reports of neonatal COVID‐19, SARS‐CoV‐2 has not been consistently isolated in perinatal samples, thus definitive proof of transplacental infection is still lacking. To address these questions, we assessed investigative tools used to confirm maternal‐fetal infection and known protective mechanisms of the placental barrier that prevent transplacental pathogen migration. Forty studies of COVID‐19 pregnancies reviewed suggest a lack of consensus on diagnostic strategy for congenital infection. Although real‐time polymerase chain reaction of neonatal swabs was universally performed, a wide range of clinical samples was screened including vaginal secretions (22.5%), amniotic fluid (35%), breast milk (22.5%) and umbilical cord blood. Neonatal COVID‐19 was reported in eight studies, two of which were based on the detection of SARS‐CoV‐2 IgM in neonatal blood. Histological examination demonstrated sparse viral particles, vascular malperfusion and inflammation in the placenta from pregnant women with COVID‐19. The paucity of placental co‐expression of ACE‐2 and TMPRSS2, two receptors involved in cytoplasmic entry of SARS‐CoV‐2, may explain its relative insensitivity to transplacental infection. Viral interactions may utilise membrane receptors other than ACE‐2 thus, tissue susceptibility may be broader than currently known. Further spatial‐temporal studies are needed to determine the true potential for transplacental migration.
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Affiliation(s)
- Aniza P Mahyuddin
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Jeslyn J L Wong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Pooja S Dimri
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Lin L Su
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Arijit Biswas
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Citra N Z Mattar
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ruby Y-J Huang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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22
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Rana A, Sharma KA, Dadhwal V. Restructuring fetal medicine services in a low-resource setting during the COVID-19 pandemic: Experience from a tertiary care fetal medicine center. Int J Gynaecol Obstet 2020; 151:291-293. [PMID: 32810903 PMCID: PMC9087649 DOI: 10.1002/ijgo.13337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Anubhuti Rana
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - K Aparna Sharma
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Vatsla Dadhwal
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
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Narang K, Elrefaei A, Wyatt MA, Warner LL, Abrao Trad AT, Segura LG, Bendel-Stenzel E, Ahn ES, Arendt KW, Qureshi MY, Ruano R. Fetal Surgery in the Era of SARS-CoV-2 Pandemic: A Single-Institution Review. Mayo Clin Proc Innov Qual Outcomes 2020; 4:717-724. [PMID: 32839753 PMCID: PMC7437475 DOI: 10.1016/j.mayocpiqo.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To cope with the changing health care services in the era of SARS-CoV-2 pandemic. We share the institutional framework for the management of anomalous fetuses requiring fetal intervention at Mayo Clinic, Rochester, Minnesota. To assess the success of our program during this time, we compare intraoperative outcomes of fetal interventions performed during the pandemic with the previous year. Patients We implemented our testing protocol on patients undergoing fetal intervention at our institution between March 1, and May 15, 2020, and we compared it with same period a year before. A total of 17 pregnant patients with anomalous fetuses who met criteria for fetal intervention were included: 8 from 2019 and 9 from 2020. Methods Our testing protocol was designed based on our institutional perinatal guidelines, surgical requirements from the infection prevention and control (IPAC) committee, and input from our fetal surgery team, with focus on urgency of procedure and maternal SARS-CoV-2 screening status. We compared the indications, types of procedures, maternal age, gestational age at procedure, type of anesthesia used, and duration of procedure for cases performed at our institution between March 1, 2020, and May 15, 2020, and for the same period in 2019. Results There were no statistically significant differences among the number of cases, indications, types of procedures, maternal age, gestational age, types of anesthesia, and duration of procedures (P values were all >.05) between the pre–SARS-CoV-2 pandemic in 2019 and the SARS-CoV-2 pandemic in 2020. Conclusions Adoption of new institutional protocols during SARS-CoV-2 pandemic, with appropriate screening and case selection, allows provision of necessary fetal intervention with maximal benefit to mother, fetus, and health care provider.
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Key Words
- ACOG, American College of Obstetrics and Gynecology
- AFPS, American Foundation for Patient Safety
- AGP, aerosol-generating procedures
- ASA, American Society of Anesthesiology
- CDH, congenital diaphragmatic hernia
- COVID-19, coronavirus-2019
- FETO, fetoscopic endoluminal tracheal occlusion
- GA, general anesthesia
- IFMSS, International Fetal Medicine and Surgery Society
- LUTO, lower urinary tract obstruction
- MAC, monitored anesthesia care
- NAFTNet, North American Fetal Therapy Network
- SMFM, Society for Maternal and Fetal Medicine
- TAPS, twin anemia polycythemia sequence
- TTTS, twin-to-twin transfusion syndrome
- WHO, World Health Organization
- qRT-PCR, quantitative real time polymerase chain reaction
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Affiliation(s)
- Kavita Narang
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
| | - Amro Elrefaei
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
| | - Michelle A Wyatt
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
| | - Lindsay L Warner
- Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN
| | - Ayssa Teles Abrao Trad
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
| | - Leal G Segura
- Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN
| | - Ellen Bendel-Stenzel
- Division of Neonatology, Department of Pediatrics and Adolescent medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Edward S Ahn
- Division of Neurosurgery, Department of Pediatrics and Adolescent medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Katherine W Arendt
- Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN
| | - M Yasir Qureshi
- Pediatric Cardiology Division, Department of Pediatrics and Adolescent medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Rodrigo Ruano
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
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Boelaert K, Visser WE, Taylor PN, Moran C, Léger J, Persani L. ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of hyperthyroidism and hypothyroidism. Eur J Endocrinol 2020; 183:G33-G39. [PMID: 32438340 PMCID: PMC7938012 DOI: 10.1530/eje-20-0445] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022]
Abstract
This manuscript provides guidance on the management of thyroid dysfunction during the COVID-19 pandemic. Autoimmune thyroid diseases are not linked to increased risks of COVID-19. Uncontrolled thyrotoxicosis may result in more severe complications from SARS-CoV-2 infection, including thyroid storm. The management of patients with a new diagnosis of hyperthyroidism is best undertaken with a block-and-replace regimen due to limited biochemical testing availability. Antithyroid drug (ATD)-induced neutropenia may favour the progression of COVID-19 and symptoms of infection may be confused with SARS-CoV-2 infection. The withdrawal of ATDs and urgent measurement of neutrophils should be considered in case of flu-like manifestations occurring in the initial months of treatment. Urgent surgery or 131-I may be undertaken in selected cases of uncontrolled thyrotoxicosis. Patients with COVID-19 infection may present with conjunctivitis, which could cause diagnostic difficulties in patients with new or existing Graves' ophthalmopathy. Patients who are on replacement treatment with thyroid hormones should ensure they have sufficient supply of medication. The usual advice to increase dosage of levothyroxine during pregnancy should be adhered to. Many newly presenting and previously diagnosed patients with thyroid dysfunction can be managed through virtual telephone or video clinics supported by a dedicated nurse-led service, depending on available facilities.
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Affiliation(s)
- Kristien Boelaert
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Correspondence should be addressed to K Boelaert;
| | - W Edward Visser
- Academic Centre for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Peter Nicholas Taylor
- Thyroid Research Group School of Medicine Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK
| | | | - Juliane Léger
- Pediatric Endocrinology Diabetology Department, Reference Center for Growth and Development Endocrine Diseases, Université de Paris, Hopital Robert Debre, Paris, France
| | - Luca Persani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Postgraduate School of Endocrinology and Metabolic Diseases, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
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